Book review

Year: 2022

Authors: Dr Gavin Francis

Rating: Entertaining 5/5 | Informative 5/5 | Inspiring 5/5

Illness is an unavoidable part of the lived human experience. Dr Gavin Francis, a renowned author and general practitioner, writes Recovery: The Lost Art of Convalescence as a manifesto for clinicians and patients alike. His aim is to alter the understanding of recovery from being a passive and prescribed journey to a singular destination, to understanding recovery as a necessary, deeply personal, and active process.

Every day there seems to be a groundbreaking medical discovery that promises to revolutionise the healthcare landscape and end the suffering of disease. Yet, although modern medicine has prevented countless cases of premature death and limited much suffering, it has only eradicated one human disease: smallpox. Therefore, we must still learn to deal with the physical and mental consequences of disease in a compassionate and effective way. Dr Francis argues that there is too little focus on the process of recovery in modern medicines. In the opening chapter, he states  “. . . we do have a literature of illness. But I’d argue that we still lack a literature of recovery.”

Dr Francis also argues that the current design of the healthcare system can work against those with chronic illness. He suggests that a doctor should be “more like a gardener than a mechanic” and tend to each patient as a whole, rather than fixing individual parts and assuming doing so will result in inevitable convalescence. Dr Francis advocates for a “balance between rest and west”, where modern treatments are used in equilibrium with more traditional concepts of healing, such as those popularised by Florence Nightingale. Nightingale emphasised the importance of pleasant surroundings, cleanliness, quiet, diet, and extended care in a patient's ability to recover.

The book successfully accounts for the societal failures that have made recovery extremely difficult for many to access—in particular, the gradual dismantling of the welfare state. There are less than half the number of hospital beds in the United Kingdom than there were 30 years ago, with mental health facilities disproportionately affected. Dr Francis also critiques changing cultural attitudes towards work and sick leave, causing more patients to feel “guilty” for taking the time off that they need to recover. The ability to recover is thus also dictated by socioeconomic stability: numerous patients simply cannot afford to take sufficient time off. 

In a livestream with the Wellcome Trust, Dr Francis discusses the themes of his book with philosopher Dr Havi Carell, who contextualises the book through her experience of living with lymphangioleiomyomatosis (a chronic lung disease), and oncologist Dr Sam Gugliani. The resulting discussion was illuminating in combining both clinical and lived experiences of convalescence, and was a great complement to a book that promotes a personalised medicinal approach that truly takes the whole person into account.